For Your Practice Medicare & Medicaid

PBPM Payments

By Courtney Hirscheider Apr 3, 2018 3 Min Read
AMS has learned from the Medicaid program that a capitation payment (PBPM) for Quarter 1 of 2018 was generated to PCMHs on March 10 with a settlement date of March 16 and some of those checks were paid incorrectly.
According to DXC some of these PBPM payments from the first distribution in the new MMIS were issued to individual PCPs, rather than their associated PCMHs. DXC will be sending out a letter to both the PCMHs and the PCPs impacted. A corrective PBPM payment will be issued to the impacted PCMHs as soon as possible.
In the meantime, DHS will be reaching out to the individual PCPs that received the erroneous payments requesting that they refund the payment. PCPs may complete their refund by either returning unprocessed checks or sending a check for the payment amount to DXC’s refund post office box which will be included in the letter. DXC will be enclosing a prepaid envelope for the PCPs to return the payment.